Carotid-cavernous fistula (CCF) is a rare and dangerous neurological disorder that arises due to an abnormal communication between the internal carotid artery (ICA) or the external carotid artery (ECA) and their branches and the cavernous sinus. It can either be a direct fistula (high-flow with acute symptoms) most commonly resulting from trauma (70-90%) or an indirect fistula (low-flow with insidious symptoms) secondary to hypertension, atherosclerosis and collagen vascular disorders. The shunting of arterial blood into the venous system leads to venous hypertension causing various clinical manifestations depending on the venous drainage patterns and the shunt flow. Increased anterior, posterior and superior venous drainage results to orbital/ocular, cavernous and cortical symptomatology, respectively. This paper aims to present a case of 58-year old Filipino female with a 2-day history of sudden, severe headache, vomiting and blurring of vision followed by decrease in sensorium and sudden proptosis and chemosis of the left eye. Patient had no co-morbidities, history of trauma, surgeries, facial skin infections or prior febrile illness. The left eye had exophthalmos, subconjunctival hyperemia, scleral edema/chemosis and ocular bruit. Neurologic examination showed a stuporous patient with multiple cranial nerve deficits (impaired direct and consensual pupillary reflex left, complete ptosis left, sluggish corneal reflex left, impaired oculocephalic reflex left), right hemiplegia and meningeal signs. Cranial Computed Tomography (CT) Angiogram revealed an acute parenchymal hemorrhage in the left frontotemporal lobe with subarachnoid component, with engorged left cavernous sinus and dilated left superior ophthalmic vein. Digital Subtraction Angiography (DSA) was done revealing a direct type of left carotid-cavernous fistula with massive ICA shunting to the cavernous sinus, superior ophthalmic vein and inferior petrosal sinus. The clinical and radiographic evidence were consistent with a Direct/Type A CCF. Unique in this case was a patient with no history of trauma presenting with simultaneous orbital/ocular, cavernous and cortical symptomatology – a clinical picture of CCF that has never been documented in any literature nor included in any classification system. The presence of all three symptomatology can be explained by a direct/highflow fistula that resulted to increased anterior, posterior and superior venous drainage as documented in the DSA. In addition, spontaneous intracranial hemorrhage in CCF is exceptionally rare and it is the most daunting symptomatology of this disease. With that, this specific case may pave the way to a new classification scheme and determine its corresponding treatment approach.
Carotid-Cavernous Sinus Fistula ; Cavernous Sinus

Among the twenty-six carotid-cavernous fistulas(CCFs) admitted to Yeungnam University Hospital from Nov. 1985 to Apr. 1994, we managed successfully by a intraoperative embolization of the cavernous sinus through the superior ophthalmic vein in two cases, which were not occluded the fistula site by the percutaneous transarterial and transvenous embolization. We exposed the cavernous sinus epidurally through the pterional approach and embolized the cavernous sinus with Surgical through the small opening at the junction of the superior ophthalmic vein entering the cavernous sinus. The surgical results were excellent.
Cavernous Sinus ; Fistula* ; Veins

No abstract available.
Carotid-Cavernous Sinus Fistula*

Intracranial extra-axial cavernous hemangioma of the cavernous sinus is a very rare vascular malformation. It usually appears as a round non-encapsulated mass with well-defined borders, mimicking meningioma. We describe a case of cavernous hemangioma of the cavernous sinus, including the radiologic imaging findings, and also review the literature.
Brain Neoplasms ; Cavernous Sinus* ; Hemangioma, Cavernous* ; Meningioma ; Vascular Malformations

Cavernous sinus thrombophlebitis may occur as a complication of infectious and noninfectious processes. Septic thrombosis of the cavernous sinuses is a serious life threatening condition, and most commonly follows midfacial skin infections due to Staphylococcus aureus. Isolated sphenoid sinusitis is a rare and elusive clinical problem, and it is an uncommon cause of cavernous sinus thrombosis. We report a case of cavernous sinus thrombophlebitis of spheoid sinusitis origin. A good result has been achieved with immediate medical measures and surgical drainage.
Cavernous Sinus Thrombosis* ; Cavernous Sinus* ; Drainage ; Sinusitis ; Skin ; Sphenoid Sinus* ; Sphenoid Sinusitis* ; Staphylococcus aureus ; Thrombophlebitis ; Thrombosis

No abstract available.
Carotid-Cavernous Sinus Fistula* ; Facial Bones* ; Humans

A case of calvarial cavernous hemangioma is presented. The tumor was located in the postero-parietal bone, which was expanded extra and intracranially. The tumor and the attached dura were excised en bloc after ligation of superior sagittal sinus which had been completely obstructed on angiography. The preoperative X-ray and operative findings are presented. The authors reviewed the previously reported cases.
Angiography ; Hemangioma, Cavernous* ; Ligation ; Superior Sagittal Sinus

No abstract available.
Cavernous Sinus* ; Dura Mater ; Meningitis ; Tuberculosis*

The authers report a case of chondroid chordoma in the cavernous sinus. The chondroid chordoma is an uncommon variant of typical chordoma(0.2% of intracranial tumors) and reported usual locations of the chondroid chordoma are clival, parasellar, intrasellar, temporal region, other skull base and extracranial areas. Reported cases of this tumor arising in the cavernous sinus is very rare. We report a case of cavernous sinus chondroid chordoma presenting with clinical symptoms by hemorrhage.
Cavernous Sinus* ; Chordoma* ; Hemorrhage ; Skull Base

No abstract available.
Carotid-Cavernous Sinus Fistula ; Facial Bones